Help! I Didn't Match: Practical Advice for Disappointed Medical Students

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So, it’s Friday again. But this is no ordinary Friday, this is Match Day. You’ve been waiting for this day your whole life. Four years of training underwhelmingly come down to a single system-generated email telling you whether you’ll be a resident the following year or not. Horrifying… I know.

As everyone starts opening up their emails (or paper letters) it’s easy to get lost in the momentum of the countless Facebook and Instagram posts from your friends who are thrilled they matched. But what if you didn’t match? Where do you take it from here? How should you feel?

Above all, you MUST know that you are special and one of a kind. You will not make a “bad doctor” or poor clinician because you did not match. The pool of applicants is becoming more and more competitive with each passing year. Average USMLE Step scores are steadily rising with each class. There are thousands of qualified applicants in the Match, and there just isn’t enough space for everyone to match into the programs they desire.

Take a deep breath…inhale….exhale. My father always told me, “you’ll end up where you belong,” and I firmly believe this statement. You will end up somewhere you will be prized and wanted, I promise. Do not let the feelings of despair overpower you; this a time where you need to focus on the next part of your application: the Supplemental Offer and Acceptance Program (SOAP).

This post covers frequently asked questions about the SOAP as well as how to start preparing for the SOAP, so let’s get started.

1. If I don’t match initially, am I guaranteed a spot through SOAP?

No, you are not guaranteed a spot. You have an opportunity to send a maximum of 45 applications to programs who are unfilled. That’s it. If those 45 programs do not offer you a position, you will have to contact whatever programs remain unfilled after the SOAP rounds end after Friday of Match Week.

2. How do I know if I’m eligible for the SOAP?

Must be registered for the Match process through ERAS and NRMP.

Must be either partially matched (prelim position but no advanced match/advanced position without prelim match) or fully unmatched.

Be eligible to start residency by July 1 (same requirements as the Match).

The R3 system will send you emails telling you if you are SOAP eligible.

3. How do I apply for programs through the SOAP?

You apply with the same two systems you used for the Match. ERAS will be the application portal, and the R3 system will be the offer acceptance/rejection portal during the 3 SOAP rounds.

4. How do I know which programs I can apply to?

ERAS will keep an updated list of unfilled programs for each round of SOAP, telling you exactly which ones you are eligible for.

5. Can I apply to a different specialty than what I was seeking?

Yes, you can even apply to unfilled neurosurgery spots if you please. However, remember you only have a maximum of 45 applications. Consider your application, Step scores, GPA, and LORs. You still must be strategic where you apply. For example, do not apply to all the unfilled orthopedic surgery programs with a barely passing Step score; you will likely not get offered any positions. However, I HIGHLY recommend thinking outside the box at this time and applying to several specialties where you can see yourself training, whether initially or permanently. You can consider taking a temporary preliminary position in order to continue your training and also have a job the following year. Preliminary surgery spots, for example, are plenty in the SOAP. If you are considering general surgery it is not a bad idea to apply to both preliminary and categorical unfilled positions and test your luck. You will at least have a fall back and possibly a job the following year if you SOAP into a preliminary position.

6. Should I reach out to programs I am interested in during Match Week outside of SOAP?

This is a big NO. Doing this will get you barred from future SOAP or Match considerations.

7. How do I get started with the SOAP?

This is similar to anything you’ve done during your medical school career. You must do your research:

Go read forums about unfilled positions and see what others have been doing on StudentDoctor.

Talk to others who have utilized the SOAP to gain positions for the following year.

As a final word of advice, it took me a long time to learn that getting great test scores does not make you a great clinician. Additionally, you don’t have to match at MGH or Yale to become an assertive and knowledgeable physician. Community programs can adequately train you (if you put in the time and effort) to become among the best clinicians in the country. These programs can also place you in the forefront of a competitive fellowships if you work hard at it. Simply put, it’s not all about where you end up; it’s about what you do with your time.

Want tutoring? Got questions? Schedule your FREE phone consult today.

Samuel Azeze MD, MPH is a graduate of St. George’s University School of Medicine in Grenada. He is currently a resident in Diagnostic Radiology at University Hospitals Cleveland Medical Center. Prior to that he completed a one year internship in Internal Medicine at Staten Island University Hospital where he had the opportunity to work one on one with medical students who have a variety of learning styles. Sam has a firm knowledge of the medical basic sciences that has been tried and tested through his clinical experience. He has impressive USMLE scores that gave him a competitive edge while applying for residency. Sam plans to stay in the academic arena as a physician and has a soft spot for teaching and mentoring.